Provider Demographics
NPI:1053886333
Name:BUZOHERA, NGALU HAROUN (HOME HEALTH AIDE)
Entity type:Individual
Prefix:MISS
First Name:NGALU
Middle Name:HAROUN
Last Name:BUZOHERA
Suffix:
Gender:F
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 DECEMBER DR APT 303
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-3615
Mailing Address - Country:US
Mailing Address - Phone:240-330-0169
Mailing Address - Fax:
Practice Address - Street 1:1510 DECEMBER DR APT 303
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-3615
Practice Address - Country:US
Practice Address - Phone:240-330-0169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA10424374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide